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What is the dest porcelain crown for someone like me who has an 'occlusion obsession'?

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MalcolmC

Junior member
Joined
May 29, 2014
Messages
1
What is the dest porcelain crown for someone like me who has an 'occlusion obsession'?

My own dental phobia is perhaps a little different from that of many other people. I'm not so much afraid of what happens when I'm in the dentist's chair (though I'm pretty afraid of that). What I'm most afraid of is what will happen to the rest of my life after I've had dental treatment. This is because I'm incredibly obsessive about how my teeth feel, especially when I'm eating. So whenever I've had a molar filling that involved more than one side, resulting in a change of its shape, it's always taken me literally years to get used to it. The same with a deep filling that is painful when I chew on it - I get to thinking about nothing else, and dreading mealtimes, for years on end.

The result is that I keep putting off going to the dentist, in case I need to have work done that will take me years of misery before I can get used to it.

This is the position I'm in now - I haven't been to a dentist since February of last year, I'm pretty sure work needs to be done in my mouth, but I can't pluck up the courage to go.

Here is the particular problem I have:


One of my rearmost upper molars (the one just next to the wisdom tooth) has a 3-sided filling, and I think it may have decayed again, so I probably need a full crown for it.

I know that gold is usually the material of choice when it comes to crowning molars, because of its durability and other material properties, but I have a phobia about having an all-metal tooth in my mouth (even if I can't see it).

Also, I am very obsessional about my occlusion, which means I hate a tooth restoration, especially with a molar, to be a different shape than the original tooth was. For this reason, that 3-sided filling has always bothered me when I eat anything. Even after 20 years, it still bothers me.


As I understand it, my choices are gold, Cerec, and laboratory-fabricated procelain, but I don't know which of the last two to ask for if I'm told I don't have to have gold.

One of my lower molars got CEREC when a corner cracked off a few years ago, and the dentist said that, as not all the tooth was there, he wouldn't take pics of the lower teeth, but instead would just photograph the upper teeth, and let the computer extrapolate what shape the crown should be to ensure proper occlusion. Well, the result was that the biting surface was nothing like the original tooth. Even the dentist said it 'looked weird'. But he had the crown milled anyway, and fitted it, and while I've never noticed any difference in chewing, the thought of its awkward shape has always bothered me.

So the obvious thought that comes into my mind is that the CEREC machine might not be able to look at my 3-sides-filled upper molar and be able to reconstruct the shape of the original tooth. On the other hand, I'm thinking that a lab technician might be able to use their expert experience to do a better job.

But on the other hand, I've heard that CEREC is better than lab because (1) CEREC uses porcelain that is stronger and more like natural tooth substance than lab fabrication does and (2) with CEREC you get a far narrower and more accurate junction between crown and tooth, meaning less chance of bacteria getting in.

Could anyone advise me, please? Thanks.
 
C

comfortdentist

Well-known member
Verified dentist
Joined
Jul 19, 2009
Messages
2,881
Location
Miami, Fl
Re: What is the dest porcelain crown for someone like me who has an 'occlusion obsession'?

first """CEREC is better than lab because (1) CEREC uses porcelain that is stronger and more like natural tooth substance than lab fabrication does and (2) with CEREC you get a far narrower and more accurate junction between crown and tooth, meaning less chance of bacteria getting in. ""
cerec is not stronger but in fact slightly weaker than lab fabricated of same material but not a big difference.

The gap or fit is neither better or worse than a lab made crown it depends on how accurate each step was done by the dentist and lab tech and which technique was used. Both can be very accurate and both can be poor.

When I have someone who has had past complaints about crowns not feeling right in a vague way or being too fat for their tongue, I take an impression of the tooth BEFORE I touch it and give that resulting model to my lab tech who can follow directions rather well.
 
B

belladee

Member
Joined
Jan 26, 2014
Messages
55
Re: What is the dest porcelain crown for someone like me who has an 'occlusion obsession'?

try and find a dentist that will do a big filling. i am a bit obsessive about my bite and after a filling i need several adjustments, the dentists always comment on how hyper sensitive I am.

I got a crown and I can not deal with it. (even if i didnt have the problems that I do with it, the feeling of it being not the way it was, makes me batty)

If you have to do it find a very good prostodontist to do it for you.
 
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